NURSE - MIDWIFE : THE STRONGEST PILLAR OF HEALTHCARE IN AFRICA

A midwife is an individual with required training and certified by the board to practice as a midwife. A midwife attends to various gynecology and obstetric cases as well the foetus. Midwife enhances maternal and child health in the global healthcare facility. Adequate and professional proficiency distinguished a midwife from an individual with a short training to reduce maternal and Infant mortality and morbidity.

Maternal and Infant mortality and morbidity is high in Africa especially Nigeria. This is due to lack of political will to combat the menace. Midwives are in shortage with poor remuneration which doesn't commensurate with the work midwives delivered.

Midwives in the rural area in Africa over-laboured, stressed up and traumatized. Patients and relatives want a midwife to attend to all of them at a time, leaving the nurse under work duress tantamount to error of commission and omission. The infrastructural decay in the primary healthcare centres is a major cause of poor maternal and child healthcare delivery.

The midwife makes use of a head lamp or kerosene lamp to take a delivery of a pregnant woman as well as suturing of lacerations. In fact, the lamp is a private property of the midwife. The midwife works at the sterilization department; to ensure all the equipment for delivery and post delivery is made available for use. Once all the sterilized equipment is used, the midwife pleads with the remaining patients for another twenty to thirty minutes for the process of sterilization which include : washing, cleaning, soaking instruments inside disinfectants and boiling then drying the instruments for re-use. When the process is completed the midwife resumes delivery of Labour. Meanwhile, there are complicated delivery which the midwife will institute a referral system.

The little available drugs is dispensed to patients. The midwife provides a comprehensive health education on care of the mother and the baby, some months after family planning is established after several counseling. The most terrible situation of it all is no assistant for the midwife, the patient's relative provides assistance based on instructions provided by the midwife.

At secondary and tertiary healthcare level where all facilities are available provides some level of professionalism for midwife even though there isn't full autonomy in the care. Midwives in Africa holds the healthcare alive, they are the backbones of the primary healthcare facility. A midwife is a professional trained person that had acquired stipulated knowledge and technical know -how in managing all conditions including pathological of women and foetus. A midwife is accessible, available and adaptable in the rural community, yet they are underpaid, no compensation, no rural allowance and underrated.

Highlighted below are possible suggestions to health organisation, health policy developers, Government (Ministry of health) and Non-Governmental Organisation

1. Establish a functional primary health care centre with adequate facilities
2. Staffing : All personnel required in the primary health care should be provided by relevant authority.
3. Midwife should be well paid and compensated. Full autonomy should be given in order not to hinder the effectiveness of midwife service.
4. Midwife should be enough at each centre during each shift to guard against over -laboured
5. Training and retraining should be instituted for midwife.